Toddler Playgroup Registration
If you would like any assistance in completing this form, please contact:

Holly Adams
Office Operations Associate, WCBVI
holly.adams@wcbvi.k12.wi.us
608.758.6148

Child's Name
Your answer
Child's Age
18-36 Months
Your answer
Child's Gender
Caregiver(s) Name
Your answer
Telephone
Your answer
Alternate Telephone
Your answer
Email
Your answer
Street Address
Your answer
City, State, Zip
Your answer
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